Dr Meldrum said some GPs were earning more money because they were now running a complex business.

He said: "The government has been encouraging GPs to expand to run super surgeries to grow bigger.

"There will be a few GPs who are at the top of these and primarily they are getting that sort of money for actually running quite a complex business rather than necessarily providing health care."

Tony Blair defended big pay rises for GPs and nurses.

He said: "When people say why have you spent so much on nurses and doctors' pay, I say because it's right we make our GPs the best paid in Europe, and boost nurses' pay and conditions, which is why the number of doctors in training is up over 68%, and nurses by 67%."

Patricia Hewitt, the Health Secretary, said GP pay was now tied to the work they actually did, rather than the size of their patient list.

"There are thousands of people who are alive and well today as a direct result of this new contract.

"This is an enormous improvement in health care, and it is the kind of preventive health care that the public want."

But she said: "I would be very surprised if there were a lot of GPs earning £250,000 purely from the NHS."

Productivity

Niall Dickson, from the independent health think tank the King's Fund, said patients were unlikely to support huge pay increases for GPs.

"All the suggestions are that GPs are being paid more money, but overall we have not seen a big increase in productivity, indeed we may have seen a down in productivity because of shut surgeries on Saturday mornings, and no responsibility for 24 hour cover.

"It does not look like a terribly good deal at the moment for the taxpayer and the patient."

Joyce Robins, of the pressure group Patient Concern, said the BMA had struck a splendid deal for its members.

"GPs are now paid piece-meal, a few thousand for reaching this target, a few thousand for that. It has created an atmosphere where it seems that every time a GP picks up a pen or looks at a computer, it must have a price tag."